Anemia and associated factors among pregnant women in South sudanese refugees in pugnido, gambela, western ethiopia

Abstract

Background: Anemia is a global public health problem that mainly affects pregnant women and children. Anemia during pregnancy results in increased feto-maternal morbidity and mortality, especially in malaria endemic areas. Inadequate access to micronutrients, malaria infection and intestinal parasitic infestation in refugee environments can play a substantial role in exposing pregnant women to anemia. Objective: To assess the prevalence, severity, type and associated factors of anemia among pregnant women in South Sudanese refugees attending antenatal care Clinic at Pugnido Administration of Refugee and Returnee Affairs Health Center, Gambela, Western Ethiopia. Methods: A facility-based cross-sectional study involving 360 pregnant women was conducted in Pugnido Administration of Refugee and Returnee Affairs Health Center from April 15 to June 30/2015. Data collection was done after obtaining informed consent. Socio-demographic, obstetric and nutritional data were collected using interviewer administered questionnaire. Mid-upper arm circumference measurement was taken. Complete blood cell counting was done using CELL-DYN 1800 (Abbott Laboratories Diagnostics Division, USA). Peripheral blood smear was examined for red blood cell morphological analysis and hemoparasite identification. Stool specimen was examined for intestinal parasites detection. Anemia during pregnancy was defined as hemoglobin concentration <11 g/dl. Statistical analyzes were done using Statistical Package for Social Sciences (SPSS) version 20.0 for windows. Association between dependent and independent variables was analyzed by logistic regression, and variables with P-value <0.05 were considered statistically significant. Result: The overall prevalence of anemia was 36.1%. Majority of the anemic pregnant women had mild form (89.2%), and the normocytic-normochromic (56.2%) type of anemia. The mean hemoglobin concentration was 11.3 ± 1.5 g/dl. Being in third trimester of pregnancy (AOR= 3.12, 95%CI:1.16-9.83), eating meat at most once a week (AOR= 2.00, 95%CI:1.11-3.58), drinking tea immediately after meal at least once a day (AOR= 3.01, 95%CI:1.74-5.22), having mid-upper arm circumference below 21 cm (AOR= 3.90, 95%CI:1.94-7.84) and intestinal parasitic infestation (AOR= 2.17, 95%CI:1.20-3.91) were significantly associated with anemia. Conclusion: Anemia prevalence was a moderate public health problem, majority of which was mild and normocytic-normochromic type. Third trimester, intestinal parasitic infestation, low mid-upper arm circumference, less frequent eating of meat and repeated tea intake had increased the risk of anemia among pregnant women. These identified factors should be considered for prevention and control of anemia with particular attention on ensuring optimal micronutrient status among the pregnant women in the study area.